I have been diagnosed with a malt lymphoma. As I understand it, this is a type of stomach cancer that has formed among the mucus membrane in my stomach wall. While the news certainly is upsetting, I am told by my growing band of health professionals that this sort of lymphoma has a very high treatment & survival rate. At present they are examining the extent of the disease, and I will have a more comprehensive diagnosis in a few weeks. Other than fatigue and emotional stress from the news, I feel fine. I do not have any overt symptoms, and that is an encouraging sign.
Usually, this area of the stomach acts as a protection to the body. Because I have allergies and asthma, I am more prone to inflammation than most people. In this case, inflammation from GERD (GastroEsophogeal Reflux Disease) led to overactive lymphocytes (our white blood cells that attack infection) and to some cells becoming abnormal.
The cancer was discovered at the end of August, after a follow-up endoscopy I had performed to check the progress in treatment for my GERD and esophogitis. Over the last few years I have had a recurring condition of inflammation in my esophagus that I finally addressed last December. The gastroenterologist performed an endoscopy at that time which showed no trace of lymphoma. In fact, he had even biopsied a polyp in the same area, which showed no lymphoma. I went on proton pump inhibitors (big doses of Prilosec), made a few lifestyle changes (no late-night eating, sleeping with head elevated), and the esophogitis has largely corrected. In the follow-up endoscopy, the doctor noticed a "strange granularity" in my stomach that he decided to biopsy. And there was the malt lymphoma.
The majority of malt lymphoma's are related to a specific bacteria, H. pylori, and can be treated completely with specialized anti-biotics. I tested negative for this bacteria. So the anti-biotic treatment is not indicated, although some health professionals think that false negatives are not uncommon.
I was told of the cancer on a Monday, saw an oncologist on a Wednesday, and had PET/CT scans on a Friday. These non-invasive scans and other blood tests confirmed the lymphoma where it was expected, although they do not give a clear picture. They also revealed some "activity" in my esophagus and lower intestine that "may or may not be significant." And my lymphocyte count is elevated, which also may not be significant, just a reaction. On Friday I am having a bone marrow biopsy to assess the lymphocyte issue. I will be having another endoscopy and an endoscopic ultrasound to map the tumor. And I may swallow a "capsule camera" to image my lower intestine. The wonder$ of technology!
With these procedures completed, the oncologist will devise a treatment regimen that will include radiation and medications. If the tumor proves to be localized, 3-6 weeks of this therapy may be enough. That's "best case," which we may have moved beyond. If there is spread of the disease, I would also have a systemic treatment -- chemotherapy of some sort.
I am generally very happy with my medical care. My long-time internist was terrific at describing the details of my condition to me and Debby. My oncologist is an eminent expert in lymphoma. He and everyone in his office have treated me promptly and with sensitivity and respect. It's a terrific surprise to see a medical office run this well. I have also begun acupuncture treatment to boost my immune system and calm inflammation. My acupuncture doctor is a 38th generation Chinese healer who runs his own Eastern medicine university. And I am aided by my brother-in-law, a physician, and my wife's uncle, a prominent medical researcher, who have offered perspectives and research for my many questions. Everyone (so far) feels this condition can be addressed successfully.
Right now, the hardest part is not knowing. The doctors, while very nice, cannot share what they do not know. So I am waiting, enjoying my kids, and trying to help Debby prepare for High Holidays. Debby has been tremendously supportive, although she also is quite shaken by the news.
I am blessed with wonderful family and friends who are nothing but supportive. I also have friends and family who have gone through their own health challenges and can offer a personal perspective. If you have questions for me about my condition or treatment, please feel free to ask.
Best wishes,
- Craig
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